• Case Selection Criteria for use with Resin-Infiltrative Treatment of Enamel Decalcification

      Raley, N; Clayton, Ashley; Fortson, WM; Deleon, E; Rueggeberg, FA; Department of Orthodontics, Department of Restorative Sciences (Augusta University, 2019)
      Although one of the primary aims for many orthodontic patients is to achieve improvement in their dental esthetic condition, a high percentage of these patients develop unesthetic, white spot lesions (WSL) during the course of treatment. These lesions develop due to enamel decalcification resulting from bacterial plaque accumulation around difficult to clean brackets and overlying wires and ligation devices. Acids produced locally in this retained plaque will decalcify enamel along the peripheral border of the bonded bracket. Quite often, despite repeated admonishment by the clinician to the patient to take extra care in cleansing these susceptible locations, patients return with large plaque deposits around the brackets, and evidence of the early stages of enamel decalcification: the so-called “white spot lesion” (WSL). The problem becomes obvious at the time of bracket removal, when, although the teeth may now be arranged in near-to-perfect alignment and occlusion, large, white areas of enamel decalcification are prominently displayed, denoting the exact location of where the bonded bracket used to be.
    • Clinical Guide for Intraosseous Pathology

      Malik, M; Kalathingal, S; Cullum, A; Buchanan, A; Abdelsayed, A; Kurago, Z; Department of Oral Biology & Diagnostic Sciences, Center for Instructional Innovation (Augusta University, 2019)
      To provide a reference database for dental students to describe and analyze intra osseous pathology that aid to develop a list of differential diagnoses for various diseases affecting the maxillofacial region on patients treated in student clinics. The online database will serve as a resource for descriptive terminology and samples to demonstrate the origin of the lesion, radiographic appearance, borders, contents, effects on adjacent structures, etc. which are the fundamental elements that guide a clinician in developing an impression and formulate the differential diagnosis. Histopathologic evaluation that provides the final diagnosis of each disease process will also be included to demonstrate that radiographic presentation of various disease categories may be similar, however, clinical management is ultimately decided by the tissue sample from the biopsy specimen. The interactive database will have various features that enable the user to access a comprehensive glossary list, word- defined searches, a brief overview of the most common diseases affecting dento-alveolar regions and learn about the management strategies.
    • Conservative Porcelain Veneer: Step by step protocol for ideal preparation

      Wooten, Rebekah; Coleman, J; Pruett, M; Romeo, M (Augusta University, 2019)
      Since the 1930s laminate veneers have been commonly used to improve appearance of teeth, but they did not become popular until enamel etching and porcelain surface treatments made them more clinically predictable in the 1980s.1 Over the years, they have been indicated to modify the color, shape, length and alignment of teeth to improve their esthetic appearance. Contraindications include severely discolored teeth and lack of enamel remaining to support the restoration.3 Treatment planning is the first step to ideal veneer preparation, which involves determining the incisal edge position, shape and proportions of the teeth being restored. This information is obtained form the diagnostic wax-up and subsequent esthetic mock-up. Veneer preparations often follow one of two common reduction patterns: conservative or standard. The difference between the two being the amount of tooth structure removed. The conservative approach involves reduction of 0.3 mm gingival third, 0.5 mm middle third, and 0.7 mm incisal third; or no reduction may be required. The standard preparation typically follows a reduction pattern of 0.8 mm gingival, 1.0 mm middle, and 1.2 mm incisal. Incisal reduction can be characteristic of either technique to allow room for the addition of incisal effects such as halo and translucency. In order to ensure porcelain veneers have the maximum lifetime expectancy, it is imperative to have preparations entirely in enamel. Bonding porcelain veneers to enamel increases their fracture strength. 2 Based on the best available evidence the ten year survival rate for porcelain veneers is at around 95% if bonded to enamel.1 Maxillary midline diastemas (MMD) are present in 28% of the population, and 87.5% of females with a midline diastema are dissatisfied and seek treatment.3 This clinical report focuses on the clinical management of a maxillary midline diastema (MMD) with porcelain veneers through a conservative preparation and incisal reduction.
    • Direct Composite restorations Using a Clear PVS Matrix to restore Worn Anterior Dentition to Create an Ideal Occlusal Plane

      Fowlkes, Colton; Romero, M; Urbanawiz, D; Department of Restorative Sciences (Augusta University, 2019)
      This clicnical case documents the use of a clear PVS matrix technique to restore the incisal edges of worn mandibular anterior teeth using flowable composite to provide a 20 degree template for eventual complete maxillary denture and mandibular removable partial denture frabrication.
    • DNA Sequencing of Extensive Odontogenic Keratocysts with Possible Therapeutic Implications

      Abdelsayed, Macarius; Kolhe, Ravindra; Abdelsayed, Rafik; Department of Oral and Maxillofacial Pathology (Augusta University, 2019)
      Purpose of this research is: to perform DNA sequencing on a group of previously diagnosed OKC of the jaws which demonstrated clinical aggressive behavior; Compare the genetic profile of the aggressive OKC cases with the genetic profile of a similar number of OKC cases which did not demonstrate aggressive clinical behavior; Evaluate the possibility of therapeutic implications of genetic mutations noted in OKCs
    • Does Time to the Operating Room Affect Outcomes in Odontogenic Infection Patients?

      Brown, Kiara; James, Jeffery; Department of Oral and Maxillofacial Surgery (Augusta University, 2019)
      Diagnosis and treatments of odontogenic infections is arguably one of the most important responsibilities of the Oral and Maxillofacial Surgeon. With a command of the complex anatomy of the head and neck region and armed with knowledge of the dentition that feeds into the physiopathology of the infection, oral and maxillofacial surgeons find themselves one of the only head and neck specialists able to treat this disease. Several decades ago, odontogenic infections were a significant source of morbidity at rates greater than 50% in some reports. The current trend in an increase in unsponsored patients seeking treatment. This trend has cost hospital centers upwards of millions of dollars per year. While some factors, such as patient medical complexity and increasing antibiotic resistance are known factors in increasing costs, a surgeon and facility dependent factor- time to the operating room- has not been studied. Understanding the effect of delayed surgical intervention is critical to fully understanding ways to mitigate costs associated with odontogenic infection patients.
    • EFFECT OF PRINT ANGULATION, MODEL RESIN, AND PRINTER ON DIMENSIONAL ACCURACY OF 3D PRINTED MODELS

      Fantaski, Lincoln; Mettenburg, D; Brenes, C; Rueggeberg, FA; Department of Restorative Sciences, Department of General Dentistry (Augusta University, 2019)
      Recent advances in the application of digital imaging of oral tissues and three-dimensional, additive fabrication techniques have led to a burgeoning industry in dentistry. Over a very short period of time, this technology has greatly improved in terms of level of surface detail reproducibility and dimensional accuracy of printed forms. Initially, thermoplastic extrusion of warmed filaments of various plastic material was used. However, the layer thickness was quite large, and surface feature reproduction was low. With advances in use of photocurable monomer resins and controlled application of photo-activating light wavelengths to provide polymerization of very thin slices of the form image, the reality of providing stoneless models of a patient’s dentition became a physical, and financial reality in private dental practices.
    • EFFECT OF TIP-TO-TARGET DISTANCE ON IRRADIANCE AMONG A VARIETY OF LED LIGHTS

      Klein, Laura; Rueggeberg, FA; Department of Restorative Sciences (Augusta University, 2019)
      Purpose of this research: To measure and compare (1) tip-to-target distance irradiance profiles (2) tip-to-target distance at which irradiance has dropped to 50% of 0-mm value (3) irradiance value at the 50% distance.
    • EFFECT OF WAVELENGTH EXPOSURE SEQUENCE ON COMPOSITE HARDNESS

      Patel, Mohit; Mettenburg, D; Rueggeberg, FA; Cellular and Molecular Biology, Department of Restorative Sciences (Augusta University, 2019)
      To measure and compare composite top and bottom surface microhardness values when using a multi-wave LED curing light emitting simultaneous blue and violet light, or when the sequence of wavelength applications was provided as separate exposures, of similar duration.
    • In Vivo Pilot Study: Effect of Dehydration/Rehydration on Upper Anterior Tooth Color Change

      Britton, Eduardo; Nappi, A; Cao, T; Shepherd, K; Department of General Dentistry, Dental Hygiene, Department of Restorative Sciences (Augusta University Libraries, 2019)
      Isolation of tooth structure during fabrication of a bonded, direct, resin-based restoration is essential to optimizing its potential for long-term clinical success. Failure to protect etched enamel and bonding agents from contamination by saliva results in inadequate and unpredictable interfacial bonding of the restorative composite, potentially leading to marginal discoloration, open margins, recurrent decay, or ultimately to restoration loss or failure. A consequence of tooth isolation during placement of direct, esthetic restorative resins is the dehydration of enamel surfaces that will not be coated with saliva, and will, over time, lose water that has penetrated into the outer enamel layers (will dehydrate). The longer the tooth isolation time, the greater will be the subsequent loss of water from enamel. Presence of this water in enamel helps to provide for a stable tooth color. In teeth, the observed tooth color is the result of internal light penetration and interaction with tissues below the surface. Enamel is a translucent material, passing a great majority of transmitted light to fall on the more opaque and yellow-colored tissue underneath of it: dentin. In the hydrated state, enamel is more translucent than in its dehydrated state. The white opaque appearance of dehydrated enamel can be of great clinical concern, once a rubber dam has been removed, and the treated teeth with newly placed restorations are observed. Usually, because of the opaque, white nature of recently dehydrated enamel, there is an initial mismatch between an esthetic restoration just placed and its surrounding, remaining enamel. Patients are normally forwarded of this consequence, and are advised that a period of time needs to pass before the surrounding enamel becomes rehydrated, and more translucent (less opaque), before its pre-isolated color returns to a natural state. It is hoped that, at that time, the new restoration will perfectly match the color characteristics of the remaining enamel, and the recent replacement will not be visible at all, but will instead optically blend in without notice. However, prior to that time, there are definitely distinct color differences between a recently placed resin restoration and its surrounding tooth structure. To date, little-to-no information is available on the rate at which a clinician or patient can expect isolated enamel to return to its pre-isolated color, and when to expect this esthetic blending to occur.
    • Influence of Porphyromonas gingivalis on Anti-Apoptotic/Autophagic Signaling Pathways in Human Dendritic Cells

      Meghil, Mohamed; Tawfik, Omnia; Elashirty, Mahmoud; Rajendran, Mythilypriya; Arce, Roger; Schoenlein, Patricia V.; Cutler, Christopher; Department of Oral Biology & Diagnostic Sciences, Department of Periodontics, Department of Cellular Biology and Anatomy (Augusta University, 2019)
      The purpose of this study was to investigate the molecular mechanisims of P. gingivalis-mediated disruption of homeostatic apoptosis and autophagy in DCs.
    • Injection of Tumescent Solution into Maxillary Sinuses During LeFort I Osteotomies for Reduction of Intra-operative Blood Loss

      Zastrow, Stephanie; James, Jeffrey; Department of Oral and Maxillofacial Surgery (Augusta University, 2019)
      Orthognathic surgery is a treatment option for many dentofacial deformities that cannot be treated with orthodontics or minor surgeries alone. Repositioning of the maxilla, mandible, chin, or a combination of the three can have a significant effect on a patient’s occlusal function, facial appearance, and self-esteem. Successful, comprehensive treatment usually requires a collaborative approach between an orthodontist and oral and maxillofacial surgeon.
    • Innate Lymphoid Cells in Periodontitis: A Novel Therapeutic Modality

      Ghaly, Mira; Emami, Golnaz; Khodadadi, Hesam; Mozaffari, Mahmood; Baban, Babak; Department of Periodontics, Department of Oral Biology and Diagnostic Sciences (Augusta University, 2019)
      To determine the presence of ILCs in human periodontium which are emerging immune cells with the potential to be targeted, via novel therapies, in the treatment of peridontitis.
    • Investigation of the Clinical Feasibility of Incorporating Dexmedetomidine into the Outpatient Anesthesia Regimen of Oral & Maxillofacial Surgery

      Taylor, D. Craig; Ferguson, Henry W.; Department of Oral and Maxillofacial Surgery (Augusta University, 2019)
      The purpose of this investigation is to evaluate incorporating a Dexmedetomidine infusion into an established IV Sedation regimen in terms of clinical efficiency (Anesthesia time), Patient subjective experience, and physiologic response to the infusion in comparison to a control appointment without the infusion.
    • Maxillary growth in patients with complete unilateral cleft lip and palate treated with Nasoalveolar molding

      Manente, M; Levy-Bercowski, D; Abreu, A; Fortson, W; Deleon, E; Yu, J; Looney, S; Department of Orthodontics; Department of Plastic Surgery; Department of Biostatistics and Data Science (Augusta University Libraries, 2019)
      In patients with cleft lip and/or palate (CLP), the nasolabial defect has a significant esthetic impact on the face and may impair psychosocial development. Nasoalveolar molding (NAM) is a pre-surgical orthopedic technique aimed to improve the alveolar and nasolabial morphology of patients with cleft lip and palate. This technique is used to facilitate and improve the future surgical correction in cleft lip and palate patients. Influences such as differences in patient age and gingivoperiosteoplasty procedures are among many that have made it difficult for conclusive results to be found and published on the impact of the NAM technique on maxillary growth in patients with complete unilateral cleft lip and palate (CUCLP).
    • A multidisciplinary approach to the management of a maxillary midline diastema: A clinical report

      Romero, Mario F.; Babb, C; Department of Restorative Sciences, Department of General Dentistry (Augusta University, 2019)
      Anterior maxillary spacing has been shown to be one of the most negative influences on self-perceived dental appearance, and a maxillary midline diastema (MMD) is commonly cited by patients as a primary concern during dental consultations. MMD has been defined as a space greater than 0.5 mm between the mesial surfaces of the 2 maxillary central incisors. An MMD greater than 2 mm in the mixed dentition is unlikely to spontaneously close. African Americans are more than twice as likely to have an MMD than whites or Hispanics. In esthetic situations, without a comprehensive smile analysis and proper planning, overtreatment and undesirable effects can occur. Tooth size especially has been emphasized as the primary element of an esthetic smile design. One method of establishing tooth size is tooth biometry as described by Chu. He reported that maxillary anterior tooth widths average 8.5 mm for central incisors, 6.5 mm for lateral incisors, and 7.5 mm for canines and that 80% of the patient population falls within ±0.5 mm of these values. Other important elements of smile analysis include the dental midline, tooth morphology, axial inclinations, and the soft tissue components of gingival health, levels, and harmony. The direct bonding technique is a straightforward, conservative method for diastema closure. However, artistic skills, a knowledge of tooth morphology, and the appropriate selection and use of composite resin materials are essential for success. According to Spear and Kokich, “some existing dentitions simply cannot be restored to a more pleasing appearance without the assistance of several different dental disciplines.” Therefore, complex esthetic dilemmas may require more than one dental discipline, for example, operative dentistry and orthodontics, to establish a functional, maintainable, and pleasant smile. This article illustrates a clinical situation in which an MMD was addressed by first completing a comprehensive smile analysis, followed by closure using limited orthodontics and direct composite resin restorations.
    • Murine Dendritic Cell Interactions with Minor-fimbriae P. gingivalis

      Yuan, J; Auersvald, c; Elashiry, M; Meghil, M; Elashiry, M; Finger Stadler, A; Arce, R.M.; Department of Periodontics (Augusta University, 2019)
      The objective was to determine DC maturity phenotype of murine bone marrow-derived DCs in response to wild/type (PgWT) and minor-fimbriated DPG3.
    • Phosphorylation of EPS8 Mediates Its Downstream Signaling and Biological Functions

      Shahoumi, Linah; Yeudall, W. Andrew; Department of Oral Biology & Diagnostic Sciences, Georgia Cancer Center (Augusta University, 2019)
      The purpose of this study was to investigate the role of EPS8 phosphorylation in modulating biochemical signaling, cell proliferation and motility in HNSCC.
    • PHOTOINITIATOR TYPES AMONG A VARIETY OF 3D PRINTING MONOMERS

      Bowerman, Brielle; Rueggeberg, FA; Brenes, C; Department of Restorative Sciences, Department of General Dentistry (Augusta University Libraries, 2019)
      A variety of manufacturing techniques have been used throughout the history of dentistry, in order to fabricate indirect restorations. Formative processes (pouring or pressing items into molds) are used when making conventional dentures, or when pressing ceramics. Recently, subtractive fabrication methods have enabled clinicians to mill a wide variety of ceramic and resin-based blanks directly into final forms, fitting the oral structures with high degrees of precision. Examples of older additive techniques include wax buildups to establish missing tooth structure for fabrication of subsequent cast restorations and the manual layering of powdered porcelains for development of ceramic facings on metallic substrates, or for ceramic veneers themselves. Tremendous advancements have been made in the field of 3D digital printing for many industrially based applications. Advances in research and development have resulted in tabletop 3D printers that produce rapid prototype specimens having very high accuracy and surface feature details. Recently, these advances have resulted in the manufacture and availability of a wide variety of 3D digital printers that dental offices now use to directly fabricate a wide range of restorative appliances (denture bases and teeth, temporary restorations, splints) as well as ancillary devices (impression trays, surgical implant guides, casts, try-in set-ups, and stents). Contemporary dental 3D printing typically involves use of near or true ultraviolet radiation (405 nm & 385 nm, respectively) in order to fabricate the basic desired form from a vat of photo-polymerizable monomers. Subsequent to initial form fabrication, the specimen is alcohol-washed of excess surface monomer, and is then subjected to an additional exposure of strong near/UV light, in order to maximize the polymerization process and provide optimal physical properties, as well as to minimize cytotoxicity resulting from leaching of unreacted, residual monomer within the bulk of the as-printed item.
    • POST-PLACEMENT IMPLANT CERVICAL BURNOUT

      Faigen, A; James, J; Stevens, M; Department of Oral and Maxillofacial Surgery (Augusta University, 2019)
      Lifetime implant success, in both esthetic and functional categories is a multifactorial process. Connective tissues, hard and soft, play a major role in the health of an implant platform and its associated restoration. While bone loss around the crestal portion of the implant up to 2.0mm within the first year of use is expected. We desire to determine factors which predict bone loss and overall implant success.. Many of the factors which can be used to account for such bone loss are inappropriate stresses and force distribution, trauma during surgery, micromechanical movement, infection, and multiple other patient factors. Bone loss has not been linked to a single implant type, placement procedure, or specialty, but remains a significant challenge in the long-term success of implants.